Human Sterilization: The History of the Sexual Sterilisation Movement
92 MENTAL WELFARE :Type: Book Reviews & Abstracts :Author: J. H. Landman, Ph.D., J.D., J.S.D. Macmillan Co. New York. 1932. Price 16/- net.
In the introduction to his book, Dr Land- man writes (with becoming modesty) that ” It purports to be a scholarly and scientific treat- ment of the available data on the subject. The conclusions are not final, but suggestive. What the question of cacogenicity, which is the crux of the entire problem of human sterilization, requires, is more science than propaganda and more research than speculation.” With the last sentiment we are in complete agreement. The book is divided into five parts : ?Part I deals with Eugenics and American Social Legislation; Part II, Human Sterilization and the Courts; Part III, The Biology of Human Sterilization; Part IV, The Surgery of Human Sterilization; Part V, Human Sterilization and Social Policy.
Statistics are furnished concerning the prev- alence of psychoses, feeble-mindedness and epilepsy in the United States together with the statutory and judicial history of the legisla- tion relating to sterilization.
As to the number of ” mentally incompetent people” in the population of the United States, the estimate of Popenhoe is quoted, the figure being nearly 10,000,000, which is roughly one- eleventh of the total population. The cost of maintenance is considered and the struggles for or against sterilization in the different States are reviewed followed by a statement of the present legal status; and in this relation Dr Landman rightly observes that ” The ex- cesses or the merits of human sterilization in this country are the results of the propaganda of the pessimistic Eugenicists,” and again, ” Our salvation thus turns on the knowledge, wisdom and justice of our legislatures.” There is a tendency in so many publications, espec- ially those from, America, to confuse the issue through treating the problems of mental deficiency and insanity as if they were iden- tical and capable of being solved in a similar manner. And the problem of the moral defec- tive (much more difficult) is studiously avoided by the majority of writers in all countries. It seems to be forgotten that the insane person is often possessed of a high degree of intelli- gence temporarily, or, may be, permanently masked by his disease.
Dr Landman is at his best when writing under the title ” A critique of Eugenics,” as in the following passage, ” How many of us realize that at the time of the discovery of America, the average American now living had 16,384 ancestors in the one ancestral generation ! One’s ancestors do multiply rapidly, two parents, four grandparents, eight great-grandparents, and so on. Hereafter, let us reserve our boasts of our great ancestors of 14 generations ago, until we know what the reputation of the other 16,383 were whom history has failed to record. Many of them might have been idiots, morons, criminals, prostitutes and other socially undesirable people.”
And after a trenchant criticism of Eugenics he adds ” Human Sterilization as a social program requires more scientific evidence. I11 the meantime if human sterilization must be employed it should be employed cautiously- The surgical methods of sterilization, vasec- tomy in the male and salpingectomy (partial or complete) in the female are described in the chapter entitled ” The Human Sterilization Operations,” and whatever results may be accepted, the fact remains that the operation in the female is a much more serious procedure and it is the sterilization of the female mental defective which is the greater problem, speculations concerning the causes and the consequences of mental deficiency there have been enough and to spare. Sterilization has been offered as the remedy and it is to that great country of America to which we must look for the results of this human experimen on a large scale. But when we turn to the Chapter XII in this book entitled “The Effects of Human Sterilization,” we find this state- ment : ” Though compulsory human steriliza” tion has been employed for about one-quartef of a century in the United States and aboil 12,000 or more individuals have already been coercively sterilized it is strange to declare tha little is known of the postoperative effects o salpingectomy and vasectomy ” … . aga*11 Before very much more is accomplished^ & applied human Eugenics through sterilizati? it is necessary to conduct a survey of those individuals who have been sterilized and ^ turned to society in order to estimate the men and demerits of the movement.” This is what every man and every woman wants to know and it is those who have conducted or have Watched this experiment in human sterilization who are capable of affording the requisite in- formation. But that information is not yet forthcoming.
We note how carefully Dr Landman has copied his medical information; for excision of the Fallopian tube is referred to as ” fallec- tomy” being printed with a small /. The word Fallopian is derived from the great anatomist Fallopius who first described the tubes that bear his name, but the word ” fallectomy ” deserved to be strangled at birth.
There is need for an investigation on scien- tific lines into the physical results of steriliza- tion, but it must be carried out by experts, for the haphazard opinions of patients, of relatives ?r of friends, recorded by lay writers with the conclusions based upon them, cannot be re- garded as a serious contribution to our know- ledge.
Dr Landman sums up by stating that Human Sterilization is not by any means the solution of the problem of the feeble-minded and the mentally diseased. Instead, it creates new problems,” and further, ” Segregation Would do all that sterilization would do in pre- senting the propagation of these social unfits out in addition remove the many dangers to society which would arise from their freedom.” The book concludes with a chapter on the -Problems in the administration of the human sterilization laws.
An extensive Bibliography is added and ar- ranged to follow each chapter, but in a book of this character it would have been better to have KiVen merely what is termed in America, “the vv?rth-while ” of the literature.
Dr Landman has written a book which is ?t value because it will enable those who read t to develop a sense of proportion on the much- reoated question of human sterilization. It ls so easy to fall a prey to the wiles of the enthusiastic propagandist who has made a ‘ tudy of the traps in which to catch the un- ary and the misinformed, and who is ever ijeady to offer tempting bait in the shape of antastic statements and doubtful statistics. n this book the subject has been treated in a ^aim and judicial manner and when it is read ?ni cover to cover the verdict that the im- partial reader feels impelled to give is that the efficacy of human sterilization as a means of racial betterment is not proven.
F. J. McC. Neurology-Psychiatry. By Peter Bassoe, M.D., and Franklin G. Ebaugh, A.B., M.D. The Year Book Publishers, Inc. Chicago. 1932. (British Agents : H. K. Lewis & Co.) In his preface Dr Bassoe says that it is his desire to make this book a critical digest rather than a more or less haphazard collection of abstracts. With such miscellaneous material this object is not easy of attainment, but a large measure of success may well be claimed. An index of the wide scope of the biblio- graphy may be found in the fact that nearly 550 separate authors are quoted or referred to on different subjects.
As a survey of recent observation and re- search it is comprehensive and useful?espec- ially in reference to the treatment of such common maladies as Epilepsy and Syphilitic diseases. The views expressed are sometimes provocative, due to the present indeterminate state of our knowledge.
The book is clearly not intended for be- ginners and assumes an acquaintance with the groundwork of nervous and mental disorders on which to impose the superstructure it pro- vides. It should prove of valuable assistance to those whose interest and work lie in the branches of science from which the title is derived.
R.W. Board of Control : England and Wales. Eighteenth Annual Report. H.M Stationery Office. Part I. 2/- net.
The Eighteenth Annual Report of the Board of Control records the results of the first year of the operation of the Mental Treatment Act, 1930. After making allowance for the ex- ceptional difficulties in working a new Act, the shortage of institutional accommodation, and the financial crisis of the State, the experience of the year confirms the belief that the Mental Treatment Act will ultimately be recognised as marking an epoch in the treatment of mental disorders.
94 MENTAL WELFARE Ninety-eight Out-Patient Clinics have been established, sixty-one being in connection with general hospitals. In certain rural areas spec- ial arrangements have been made to meet the needs of patients in out-lying districts. It is suggested that in similar areas application might be made to the Local Education Author- ities with a view to utilising the School Clinics for this purpose.
Voluntary In-Patient Treatment and Tempor- ary Treatment.
In the case of private patients the number of voluntary and temporary patients exceeded those under certificate.
Of the total direct admissions into all forms of care:?84% were admitted under Order; 14% were received as Voluntary Patients; and 2% were received as Temporary Patients.
It is suggested that certain certified patients who have greatly improved but are likely to require prolonged institutional treatment could in future be graded as voluntary patients with decided gain to their sense of self- respect. The number of admissions of tem- porary patients under Section 5 of the Mental Treatment Act has been disappointingly small.
Many non-volitional cases have been sent in under certificate when use could have been made of the new provision.
Accommodation.
The whole question of accommodation both for cases of mental disorder and for mental defectives is serious and it is evident that the growing overcrowding of Mental Hospitals is largely due to the absence of accommodation elsewhere for mental defectives.
An investigation of 449 mental defectives in two Mental Hospitals resulted in the following classification : ?
Suitable for removal to a Colony … 173 Suitable for removal to a Public Assist- ance Institution … … 61
Should remain in the Mental Hospitals 72 As the cost of a Colony Bed for defectives is about ?300 and the estimated cost of a Mental Hospital Bed is ?500, considerable economy would be effected by the removal of suitable defectives to Colonies.
Ascertainment of Mental Defectives.
Under this heading and elsewhere, attention is drawn to the serious results of retarded ascertainment, especially in the case of violent and dangerous defectives and those who are charged with offences. The ratios of ascertain- ment vary from 7.23 to 0.23 per 1,000 of the population, the total number reported by Local Authorities for the year being 97,310, an increase of 11,347.
Community Care.
In view of the shortage of institutional ac- commodation defectives must be dealt with by improved methods of community care. Great importance is attached to a judicious use of Licence, experience having shown that the risks can be minimised if good judgment and systematic care are exercised. Of 152 on licence from a large Certified Institution only 6 were returned, 4 as being unsuitable and 2 for bad behaviour.
The selection of Guardians under Guardian- ship Schemes presents considerable difficulty and their selection and instruction should forrn a definite part of every Local Authoritys Mental Deficiency service. The increase ?t Guardianship cases for the year is 315, the total being 2,147.
There are sometimes limitations to the suit- ability of parents as Guardians, the tendency of some being to regard the allowance aS simply Poor Law Relief and others accepti*1^ the allowance and denying the existence ?t mental deficiency in the child.
There are now 182 Occupation Centres func’ tioning, 45 being conducted by Local Author- ities and 137 by Voluntary Associations. Ho11}0 Teaching is being systematically organised 111 four areas, Middlesex, Suffolk, Gloucester- shire loint Board, and Wiltshire.
Marriage of Defectives.
The number reported for the year is The figures are probably under the actua ones, as ascertainment is still incompl^^’ Nevertheless, the marriages reported for year confirms the Board in the opinion legislative action should be taken to preve*1 the marriage of defectives who have bee placed under Order.
Mental Defectives and Crime.
Three hundred and six mentally defect1^ offenders were dealt with under the ^e?ty Deficiency Acts. One hundred and thtf > three offences were of a serious nature. ^ incidence of crime among the 306 defectrv^ reached its highest point between the ages ?. 14 and 21, after which it steadily decrease
Eighty-two per cent, of the cases came to the knowledge of the Local Authorities after the commission of some offence and sixty-three of the cases had already been in some form of institutional care. Although from the informa- tion recorded about many of these 63 cases the defect must have been recognisable in child- hood, it appears to have been undetected or to have been regarded as no bar to discharge. M.D.
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